NR341/NR 341 Exam 2 V3 | Complex Adult
Health Q&A with Rationale | Chamberlain
University
1. A patient is admitted with a suspected pulmonary embolism. Which diagnostic test is
considered the gold standard for confirming this diagnosis?
A. Chest X-ray
B. D-dimer assay
C. CT Angiography (CTPA)
D. Arterial Blood Gas (ABG)
Correct Answer: C
Expert Explanation: Computed Tomographic Pulmonary Angiography (CTPA) is the
primary diagnostic tool used to visualize pulmonary emboli in the vascular system. While
D-dimer is useful for screening, it lacks the specificity needed for a definitive diagnosis.
Chest X-rays are often normal in PE patients and are primarily used to rule out other
conditions such as pneumonia.
2. A nurse is caring for a patient on mechanical ventilation. The high-pressure alarm sounds.
Which of the following is the most likely cause?
A. Disconnection of the ventilator tubing
B. Excessive secretions in the airway
,C. A leak in the endotracheal tube cuff
D. Patient self-extubation
Correct Answer: B
Expert Explanation: High-pressure alarms are triggered when the ventilator meets
resistance, such as secretions, bronchospasm, or the patient biting the tube. In contrast,
low-pressure alarms typically indicate a disconnection or a leak in the system. The nurse
must quickly assess the patient, suction if necessary, and ensure the airway is clear.
3. A patient in the ICU has the following ABG results: pH 7.28, PaCO2 50, HCO3 24. How
should the nurse interpret these findings?
A. Partially compensated respiratory acidosis
B. Fully compensated metabolic alkalosis
C. Uncompensated respiratory acidosis
D. Uncompensated metabolic acidosis
Correct Answer: C
Expert Explanation: The pH of 7.28 indicates acidosis, and the PaCO2 of 50 indicates a
respiratory cause. Since the bicarbonate level (HCO3) is within the normal range of 22-26,
no compensation has occurred yet. Therefore, this is classified as uncompensated
respiratory acidosis, often seen in hypoventilation.
, 4. During the management of a patient in septic shock, which hemodynamic parameter is the
primary target for fluid resuscitation therapy?
A. Pulmonary Artery Wedge Pressure (PAWP) of 18 mmHg
B. Heart Rate of 110 bpm
C. Mean Arterial Pressure (MAP) of 50 mmHg
D. Central Venous Pressure (CVP) of 8-12 mmHg
Correct Answer: D
Expert Explanation: According to the Surviving Sepsis guidelines, a CVP goal of 8-12
mmHg is often used to guide initial fluid resuscitation. Achieving this target suggests
adequate preload to support cardiac output and tissue perfusion. If the patient is
mechanically ventilated, the target CVP might be slightly higher due to increased
intrathoracic pressure.
5. A nurse is titrating Norepinephrine (Levophed) for a patient in distributive shock. What is
the primary mechanism of action for this medication?
A. Potent vasodilation of the peripheral vasculature
B. Pure beta-1 stimulation to increase heart rate
C. Inhibition of phosphodiesterase to increase contractility
D. Alpha-1 adrenergic stimulation causing vasoconstriction
Correct Answer: D
Health Q&A with Rationale | Chamberlain
University
1. A patient is admitted with a suspected pulmonary embolism. Which diagnostic test is
considered the gold standard for confirming this diagnosis?
A. Chest X-ray
B. D-dimer assay
C. CT Angiography (CTPA)
D. Arterial Blood Gas (ABG)
Correct Answer: C
Expert Explanation: Computed Tomographic Pulmonary Angiography (CTPA) is the
primary diagnostic tool used to visualize pulmonary emboli in the vascular system. While
D-dimer is useful for screening, it lacks the specificity needed for a definitive diagnosis.
Chest X-rays are often normal in PE patients and are primarily used to rule out other
conditions such as pneumonia.
2. A nurse is caring for a patient on mechanical ventilation. The high-pressure alarm sounds.
Which of the following is the most likely cause?
A. Disconnection of the ventilator tubing
B. Excessive secretions in the airway
,C. A leak in the endotracheal tube cuff
D. Patient self-extubation
Correct Answer: B
Expert Explanation: High-pressure alarms are triggered when the ventilator meets
resistance, such as secretions, bronchospasm, or the patient biting the tube. In contrast,
low-pressure alarms typically indicate a disconnection or a leak in the system. The nurse
must quickly assess the patient, suction if necessary, and ensure the airway is clear.
3. A patient in the ICU has the following ABG results: pH 7.28, PaCO2 50, HCO3 24. How
should the nurse interpret these findings?
A. Partially compensated respiratory acidosis
B. Fully compensated metabolic alkalosis
C. Uncompensated respiratory acidosis
D. Uncompensated metabolic acidosis
Correct Answer: C
Expert Explanation: The pH of 7.28 indicates acidosis, and the PaCO2 of 50 indicates a
respiratory cause. Since the bicarbonate level (HCO3) is within the normal range of 22-26,
no compensation has occurred yet. Therefore, this is classified as uncompensated
respiratory acidosis, often seen in hypoventilation.
, 4. During the management of a patient in septic shock, which hemodynamic parameter is the
primary target for fluid resuscitation therapy?
A. Pulmonary Artery Wedge Pressure (PAWP) of 18 mmHg
B. Heart Rate of 110 bpm
C. Mean Arterial Pressure (MAP) of 50 mmHg
D. Central Venous Pressure (CVP) of 8-12 mmHg
Correct Answer: D
Expert Explanation: According to the Surviving Sepsis guidelines, a CVP goal of 8-12
mmHg is often used to guide initial fluid resuscitation. Achieving this target suggests
adequate preload to support cardiac output and tissue perfusion. If the patient is
mechanically ventilated, the target CVP might be slightly higher due to increased
intrathoracic pressure.
5. A nurse is titrating Norepinephrine (Levophed) for a patient in distributive shock. What is
the primary mechanism of action for this medication?
A. Potent vasodilation of the peripheral vasculature
B. Pure beta-1 stimulation to increase heart rate
C. Inhibition of phosphodiesterase to increase contractility
D. Alpha-1 adrenergic stimulation causing vasoconstriction
Correct Answer: D
